A first-of-its-kind mental health survey of police, firefighters and 911 call dispatchers in Virginia finds that they experience suicidal thoughts at a rate of more than double the general population and that nearly a quarter suffer from work-related depression.

The survey of nearly 4,900 first responders also found that nearly half couldn't stop looking for threats even in their own homes, a common symptom for those who have been exposed to trauma.

Many said they would not seek help for their problems, because they wanted to tough it out on their own, feared their bosses finding out, or felt too embarrassed to ask because of the stigma associated with mental health issues.

The survey of 26 agencies across the state by the Fairfax County police, the U.S. Marshals Service and the Fairfax Coalition of Police Local 5000 comes as the psychological toll of public safety work has begun to gain more national attention. Studies show police officers and firefighters are more likely to die by suicide than in the line of duty.

Fairfax County Police Chief Edwin Roessler said the survey underscores that departments nationwide need to do more to address the mental health of their first responders and confront issues that have been taboo for too long.

"We need to do a better job," said Roessler, who has suffered from post-traumatic stress disorder and sought treatment. "It's going to take a long time to get rid of this stigma."

Nearly 8 percent of the first responders surveyed admitted to recently having thoughts of suicide, which is higher than what the survey cited as a 3 percent rate among the general population of the United States.

The survey found that the percentage of first responders who reported depression increased the longer they worked. Of those who had been on the job less than five years, 12.5 percent reported feeling depressed, but that number nearly doubled to 24.6 percent among those with six to 10 years of experience; it kept climbing after that.

"If we are going to stop the suicide epidemic among first responders, we need to be open-minded in treating the depression," said Jaysyn Carson, director of Incident Support Services for the Fairfax County police. "The depression is the result of repeated exposure to traumatic events."

Carson said he is aware of six suicides in the department in the past six years, including two of his original squadmates. Carson said the experience deeply affected him - he said one of the officers reached out to him the day before he died by suicide - and was one of the reasons he worked to create the survey.

A suicide in the Fairfax County Fire Department in 2016 generated national attention and led to a raft of new mental health programs.

The rate at which first responders take their own lives is the subject of debate, since not all departments report the figures and the Justice Department does not issue a nationwide tally.

Still, one study found that police officers had a 69 percent higher risk of suicide than the general population. A group called Blue H.E.L.P. has tracked 142 suicides among police officers in 2019. There were 167 last year and 169 in 2017, according to the group's tally. In 2018, 144 police officers died in the line of duty, according to the National Law Enforcement Officers Memorial Fund.

Professor John Violanti of the State University of New York at Buffalo, who has studied police suicide, likened the stresses of law enforcement to that of soldiers at war, carried out over a much longer period.

"They see this terrible stuff all the time," Violanti said. "They are exposed to this stuff for almost 20 to 25 years over the course of a normal career. The problem with trauma is it's cumulative. The more trauma you experience, the more likely you are to get PTSD. It affects ability to perform. You can't sleep. You become afraid to step outside."

Violanti said many departments have gotten better at helping first responders receive help in the past five to 10 years, but others have been slow to change. Violanti said that the top-down military structure of many agencies makes it difficult for rank-and-file officers to communicate problems up the chain of command and that it is reinforced by a culture that prioritizes stoicism and toughness.

"The police culture is one that demands you almost never show a weakness," Violanti said. "Officers get upset when they have these problems and don't know what they can do."

Police suicide in particular has received attention this year because the New York City Police Department has been rocked by nine, while the Chicago Police Department experienced six in an eight-month stretch.

In July, President Donald Trump signed a bill that would allocate up to $7.5 million in grants for police suicide prevention, mental health screenings and tools to identify officers who may be at risk. In April, 300 police chiefs from across the country and around the world met in New York City to discuss officer suicide.

Fairfax County police have implemented or are looking at a number of tools to help officers with mental health problems, Roessler said. In recent weeks, the department launched a program that uses dogs to help front-line officers with the stress of the job.

Roessler created a video to show to officers about police suicide, and wellness checks are required for each officer. One proposal is to create a public wellness safety center in the county.

"We generally get called to the worst things someone can do to someone else," Roessler said. "It takes its toll on a human being."

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